Impact of structural heart disease on the acute complication rate in atrial fibrillation ablation: results from the German Ablation Registry
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Impact of structural heart disease on the acute complication rate in atrial fibrillation ablation: results from the German Ablation Registry. / Hoffmann, Boris A; Kuck, Karl-Heinz; Andresen, Dietrich; Spitzer, Stefan G; Hoffmann, Ellen; Schumacher, Burghard; Eckardt, Lars; Brachmann, Johannes; Becker, Rüdiger; Steven, Daniel; Rostock, Thomas; Jünger, Claus; Senges, Jochen; Willems, Stephan.
In: J CARDIOVASC ELECTR, Vol. 25, No. 3, 03.2014, p. 242-249.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Impact of structural heart disease on the acute complication rate in atrial fibrillation ablation: results from the German Ablation Registry
AU - Hoffmann, Boris A
AU - Kuck, Karl-Heinz
AU - Andresen, Dietrich
AU - Spitzer, Stefan G
AU - Hoffmann, Ellen
AU - Schumacher, Burghard
AU - Eckardt, Lars
AU - Brachmann, Johannes
AU - Becker, Rüdiger
AU - Steven, Daniel
AU - Rostock, Thomas
AU - Jünger, Claus
AU - Senges, Jochen
AU - Willems, Stephan
N1 - © 2013 Wiley Periodicals, Inc.
PY - 2014/3
Y1 - 2014/3
N2 - INTRODUCTION: Catheter ablation (CA) has emerged as a widespread therapeutic option in the treatment of atrial fibrillation (AF). Currently, no safety data with regard to the impact of the underlying structural heart diseases (SHD) are available. We sought to assess the risk for acute and long-term complications during CA of AF in relation to underlying SHD.METHODS AND RESULTS: We included 6,211 patients in a prospective registry undergoing CA of AF in 41 nationwide centers. All patients were divided into 4 groups according to the underlying heart disease: No SHD (69.4%), hypertensive heart disease (HHD) (12.0%), coronary artery disease (CAD) (15.1%), and cardiomyopathy (CM) (3.6%). In univariate analysis, patients with HHD had an overall complication rate of 7.28%, whereas patients without an SHD had a significantly lower rate of 6.01% (P < 0.01). Multivariate analysis revealed that HHD (adjusted odds ratio [OR]: 1.97 [95% confidence interval (CI): 1.02-3.83], P = 0.0442) and age (years; OR: 1.04 [95% CI: 1.01-1.07], P = 0.0155) were independent predictors of severe, nonfatal complications and death. Other SHD including CAD (OR: 1.48 (0.73-3.00), P = 0.2797) and CM (OR: 2.37 [0.70-7.99], P = 0.1630) failed to reach statistical significance. Male sex was protective (OR: 0.47 [95% CI: 0.27-0.81], P = 0.0062).CONCLUSION: In general, CA of AF has a low number of severe complications. In our prospective registry HHD emerged as an independent predictor of severe, nonfatal complications during AF ablation but other SHD including CAD and CM did not. The influence of HHD on the complication rate should be considered in patient selection.
AB - INTRODUCTION: Catheter ablation (CA) has emerged as a widespread therapeutic option in the treatment of atrial fibrillation (AF). Currently, no safety data with regard to the impact of the underlying structural heart diseases (SHD) are available. We sought to assess the risk for acute and long-term complications during CA of AF in relation to underlying SHD.METHODS AND RESULTS: We included 6,211 patients in a prospective registry undergoing CA of AF in 41 nationwide centers. All patients were divided into 4 groups according to the underlying heart disease: No SHD (69.4%), hypertensive heart disease (HHD) (12.0%), coronary artery disease (CAD) (15.1%), and cardiomyopathy (CM) (3.6%). In univariate analysis, patients with HHD had an overall complication rate of 7.28%, whereas patients without an SHD had a significantly lower rate of 6.01% (P < 0.01). Multivariate analysis revealed that HHD (adjusted odds ratio [OR]: 1.97 [95% confidence interval (CI): 1.02-3.83], P = 0.0442) and age (years; OR: 1.04 [95% CI: 1.01-1.07], P = 0.0155) were independent predictors of severe, nonfatal complications and death. Other SHD including CAD (OR: 1.48 (0.73-3.00), P = 0.2797) and CM (OR: 2.37 [0.70-7.99], P = 0.1630) failed to reach statistical significance. Male sex was protective (OR: 0.47 [95% CI: 0.27-0.81], P = 0.0062).CONCLUSION: In general, CA of AF has a low number of severe complications. In our prospective registry HHD emerged as an independent predictor of severe, nonfatal complications during AF ablation but other SHD including CAD and CM did not. The influence of HHD on the complication rate should be considered in patient selection.
KW - Aged
KW - Atrial Fibrillation/diagnosis
KW - Catheter Ablation/adverse effects
KW - Female
KW - Follow-Up Studies
KW - Germany/epidemiology
KW - Heart Diseases/epidemiology
KW - Humans
KW - Male
KW - Middle Aged
KW - Postoperative Complications/diagnosis
KW - Prospective Studies
KW - Registries
KW - Treatment Outcome
U2 - 10.1111/jce.12319
DO - 10.1111/jce.12319
M3 - SCORING: Journal article
C2 - 24237758
VL - 25
SP - 242
EP - 249
JO - J CARDIOVASC ELECTR
JF - J CARDIOVASC ELECTR
SN - 1045-3873
IS - 3
ER -